Youth at high risk of suicide may be less likely to engage in self-harm following dialectical behavior therapy (DBT) compared with individual and group supportive therapy (IGST) due to improvements in their ability to regulate emotions. Data from a previous trial of 173 youth aged 12 to 18 years who had elevated past-month suicidal ideation and a history of prior suicide attempts and repeated self-harm episodes. Compared to IGST, greater improvements in youth emotion regulation were found in DBT through the treatment-period. Their parents reported using more DBT skills: post-treatment. Mediation analyses predicted to self-harm remission during the 6-12-month follow-up, the pre-specified outcome because this was the only suicidality/self-harm variable with a significant DBT effect at follow-up. Improvements in youth emotion regulation during treatment mediated the association between DBT and self-harm remission during follow-up . Youth in DBT reported lower substance misuse, externalizing behavior, and total problems at post-treatment/6-months, and externalizing behavior through follow-up/12-months. The investigators concluded that the results support the significance of emotion regulation as a treatment target for reducing self-harm, and indicate a DBT advantage on substance misuse, externalizing behavior, and self-harm-remission, with 49.3% of youth in DBT achieving self-harm remission during follow-up.
The findings were published online Feb. 1 in the Journal of the American Academy of Child & Adolescent Psychiatry in February 01, 2021DOI:https://doi.org/10.1016/j.jaac.2021.01.016.